This proposal seeks support for a monograph on the history of rheumatic fever. The project is well underway with most of the published material identified and read. I have completed preliminary drafts of eight chapters. Specifically, what this proposal requests is (year 1) summer travel funds to London to allow research in primary source materials unavailable in the United States, and (year 2) partial salary support for principal investigator and secretary. The method selected for the initial section of the monograph ("Emergence of the Clinical Entity of Rheumatic Fever, 1810-1890") is an ecological one that argues that rheumatic fever emerged in the nineteenth century because the biological, institutional, technological, and theoretical aspects of rheumatic fever's "ecology" shifted attention away from the older diagnosis of "rheumatism" with its emphasis on fever and joint pain to injury done to the heart as the clinically-most-significant aspect of the disease. This evolution largely occurred under the observation of London physicians. The method selected for the second section of the monograph (the streptococcal connection) is to focus on two laboratories; Frederick J. Poynton and Alexander Paine's laboratory in London and Homer Swift's in New York City. Poynton and Paine were early and effective proponents of the idea that rheumatic fever was a form of streptococcal sepsis; Swift eventually argued that rheumatic fever was a streptococcal allergy. The method chosen for the final section (the decline of rheumatic fever) focuses on four settings where practitioners and patients interacted: 1) patients' homes using material from May G. Wilson's decades of home visits; 2) cardiac clinics (Caroline Bedell Thomas' clinic at Johns Hopkins; 3) cardiac convalescent hospital (Good Samaritan in Massachusetts); 4) surgical operating room.